Community Support Programme2021 Application Form

CONTENTS

PART ONE: ABOUT YOUR ORGANISATIONPass / Fail

Page

Section A: Contact information 2

Section B: Your organisation 3

Section C: Running your organisation 4

PART TWO: ABOUT YOUR PROGRAMME OR PROJECTWeighted score

Section D: Planning to meet needs 6

Section E: How you will deliver 9

Section F: Funding to deliver 10

PART THREE: MAKING A DIFFERENCEWeighted score

Section G: Making a difference 12

Section H: Funder Targeting 16

PART FOUR:DETAILS and DECLARATIONPass / Fail

Bank, acknowledgement and signatures 17

PART FIVE - CHECKLIST 18

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Section A: Contact information 1. Legal name of your organisation      

2. Main contact for the group

First and Last name      

Position in group      

3. Contact details for group

Address      

Postcode      

Telephone      

Email      

4. Correspondence details for main contact if different to above

Address      

Postcode      

Telephone      

Email      

5. Where your group operates from (tick one only)

A hall or commercial property on which you hold the lease

A house or flat; or other premises hired on a weekly or daily basis

No fixed address but you use venues now and then as need

PART ONE: ABOUT YOUR

ORGANISATION

Part One is made up of sections A, B and C. Each is marked ‘pass’ or ‘fail’ based on your answers and supporting documentation.

All sections must be rated ‘pass’ for an application to move on to the next phase of assessment. The boxes will expand as you type into them.

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Section B: Nature of your organisation

All of these need be true. You need to provide the supporting documentation indicated.

1. Your organisation is a formally constituted non-profit distributing community / voluntary organisation.

Tick if true and you have sent your constitution or articles of association.

2. Charity Commission NI registration number      

Registration pending. Give month and year applied      

Reason we have not applied or are not on the register. Please call for advice before      completing this form

3. Your organisation been operating for more than 12 months. Give month and year formed in MM/YYYY format      

4. Your organisation is based in and delivering services in the Lisburn and Castlereagh City Council area. Tick if true.

OR

Your proposed project is delivered entirely within the Lisburn and Castlereagh City Council area. Tick if true.

5. What is the main purpose of your organisation? (Briefly describe in a couple of sentences)      

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Section C: Running your organisation

1. Your organisation has adequate insurance cover in place. Please read our Insurance Policy Guidance Notes. Tick if true and copies of insurance certificates (and quotations if for a forthcoming event) have been sent

2. You have appropriate policies for

Health and Safety Tick if true and copy of policy provided

Safeguarding Tick if true and copy of policy provided

List any other policies directly relevant to the work to be funded. We may need to see these,but you need not send now.      

3. Your organisation has a bank or building society account that requires at least two unrelated people to sign any withdrawal. Tick if true and give details in Part 4

4. Your most recent annual accounts. Tick to show signed copy of latest checked or audited accounts provided AND summarise below

Accounts for year ending. Give date MM/YY      

Total income for the period £      

Total expenditure for the period £      

Income minus and expenditure £      

5. The number of people involved in running your organisation during the past year

Committee (Board) members      

Volunteers (not counting committee members)      

Staff      

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The following questions are about your work in general, not only the work for which you seek funds. They are marked ‘pass’ if they provide the evidence sought and ‘fail’ if not. Please read the section on the ‘Assessment Process’ in the accompanying guidance and give concise answers of up to 200 words per question below.

6. Describe who is responsible for decision making, reporting and monitoring of

a. Programme delivery and

b. Finances      

7. How do you replace and recruit Committee members and any other volunteers?      

8. How do you ensure that Committee members and any other volunteers have the skills they need? Please give an example from the past 12 months      

9. In what ways does your organisation connect with other organisations for support or advice? Please give anexample from the past 12 months      

10. How do you know that the work of your organisation makes a difference? Please give an example from the past 12 months      

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Section D: What do you plan to do and for whom?

1. Below please outline your Annual Programme during the life of the grant

Name of activity, short description and location Start and end months

Number of direct participants or users*

Total number of participants or users during the lifetime of the grant (do not include committee members or those delivering services)

Total

* By direct, we mean the people who use or directly benefit from your activities or services during the lifetime of the grant. Do not include other people who may subsequently benefit (indirect beneficiaries).

PART TWO: ABOUT YOUR PROGRAMME OR PROJECT

Part Two is made up of sections D and E. These seek to find out what you plan to do, for whom, and why.

Each element is scored as shown in the evidence criteria. Applications must score over 50% of the maximum in order to move on to the next stage of assessment

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2. Is your work targeted at a particular section of the community? Tick just the main groups relevant.

This helps us to better understand your work.

It is not scored.

Age: Everybody – no targeted group      

Children under 16      

Young people 17 to 24      

Adults aged 25 to 64      

Older people over 65      

Community:Everybody - no targeted population      

People living with low income      

Disabled people      

People who are unemployed      

People from minority ethnic groups      

Other specific community or group      

Please state      

Please give short and clear answers of 50 to 200 words for each question below.

3. Please describe the community needs behind your programme and how you asked the people who might take partwhat would best meet their needs      

4. How does the work fit in with or complement what others are doing?      

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Section E: How will you deliver?

Please give short and clear answers of 50 to 200 words for each question

1. How many people will directly deliver this work? Give your best estimate

Committee (Board) members      

Volunteers (not counting committee members)      

Our staff      

Freelance workers      

What skills and experience does this team bring to ensure good standards?      

2. Will you need to work with any other groups or organisations to make parts of your project a success?

     If so, please describe which groups and what they will be doing. And, if not, please state why.

3. How will you get word out and encourage people to get involved?

     If relevant, please address how you will attract people from diverse backgrounds or excluded groups.

4. What barriers might there be to people taking part and how will youtry to address these?      

5. What, if any, issues might prevent or hinder success and what steps will you take to avoid or overcome these?

     Some of these may be relevant: Lack of volunteers

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Lack of funding Health and Safety

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Section F: How much money do you need?

Which of the following does your group operate from (Please tick only 1)?

☐ £5500 (Community/Village Hall/Commercial Premises) -Lease Holder only.

☐ £4250 (Community Flat/House or Hired Premises)- Hired Premises on a Daily/Weekly basis

☐ £2500 (No Premises)

1. Please give all programme expenditure and identify the elements that make up your grant request to LCCC. Group similar costs together and round to the nearest £50.

Item / Activity Total cost Amount requested of LCCC

Total Core Costs e.g heat, light, insurance,rent etc

£ £

Total non-core Programme Costs: e.g Training, annual programme etc

£ £

GRAND TOTAL £ £

2. Below list any funds you aim to raise from donations, fees or sales, giving the source where known.

Source Cash or In kind? Value Target date

Total £

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3. If you expect grants from other funders please list below any applications planned or made.

Name of funder Total requested

Date applied

Sum approved or date will know

TOTAL £ £

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For this grant, the differences we are interested in are the direct results you expect to happen while the work is taking place or soon after.

These might benefit:

Your own organisation

Your direct participants or service users

The wider community

Outcomes for the Community Support Programme are listed below. We recognise your programme may contribute towards more outcome. However, we do not expect grants to contribute to all of them and are most interested in the benefits that best fits your funded work.

Once you have selected the most relevant outcomes, we ask you to complete an outcomes statement for each.

You will not be penalised for only two outcomes as we use your average score across all you select.

We do expect the sophistication of the information you provide in your outcomes statement(s) to be proportionate to the capacity and size of your organisation and the scale of the funded work.

We will be basing our assessment on how clearly the outcomes you select link to your activities and how realistic your plans are for showing that outcomes have happened – or if not, to understand why not. (Please see the assessment criteria).

Further on, we provide guidance on what we are asking for in the outcomes statement, and a completed example.

PART THREE: THE DIFFERENCE YOU AIM TO MAKEPart Three is made up of sections G and H. These seek to find out the beneficial difference you plan to make through the work you want the grant to support.

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Section G: Making a difference

1. In the list below, please tick ONE priority. Then tick ONE, TWO OR THREE of the outcomes beneath it. You may not select more than one priority.

You may not tick outcomes under a priority other than the one you have selected.

Once ticked, please complete an outcomes statement for the outcome(s) selected. See next page for an example.

Priority 1 : Our organisation will benefit because ….Outcome 1:1 We will attract volunteers or committee members of different ages or backgrounds

Outcome 1:2 We will boost committee, volunteer or staff skills for delivering our work

Outcome 1:3 We will improve the quality of our work through research, testing new approaches, partnerships or in some other way

Priority 2 : Participants or users will benefit because…..Outcome 2:1 They will connect with other people and avoid social isolation

Outcome 2:2 They will develop their knowledge, skills or abilities

Outcome 2:3 They will gain confidence to identify or speak out about issues affecting them

Priority 3: Wider benefitsOutcome 3:1 We will inspire more or different people to take part in the community

Outcome 3:2 We will make available our own or other services to communities that may be excluded

Outcome 3:3 We will help bring together organisations in and across sectors: voluntary and business or public sector

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Example Outcome Statement

Here is a made up example. It uses 135 words. You can use up to 200 words (not counting the outcome name itself).Complete one statement for each of the one or two outcomes you selected.

A. Name of the outcome or benefit you aim to create and report on (from list)

Outcome 1:2 We will boost committee, volunteer or staff skills for delivering our work

B. Describe what will improve and for who or what during or just after the work

Our coordinator will get more expert skills in planning. Our committee get better at understanding plans and will get better plans. This will make our whole group stronger.

C. Describe how you expect to this change to arise from your activities

Our coordinator will get fees and paid time off to attend planning training session. She will then come back and share skills in understanding plans with the Committee members at a special skills sharing meeting.

D. Describe how you will show that this improvement is happening or happened (or will know that it is not so you can learn and improve)

We will monitor that she attends all training. We will record how many committee members come to the skill sharing meeting. We will ask the coordinator and committee members to report on what they learned, if it was useful and worthwhile. We will ask what training they would like next. We will use a survey for this and write a short report.

There are blank statements for you to use below Complete a statement for each of the two, three or four outcomes you ticked.

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Your Outcome Statements

Complete a statement for each of the two, three or four outcomes you ticked.

Outcome StatementA. Name of the outcome you aim to create and report on (from list)

     

B. Describe what will improve and for who or what during or just after the work

     

C. Describe how you expect to this change to arise from your activities

     

D. Describe how you will show that this improvement is happening or happened (or will know that it is not so you can learn and improve)

     

Outcome StatementA. Name of the outcome you aim to create and report on (from list)

     

B. Describe what will improve and for who or what during or just after the work

     

C. Describe how you expect to this change to arise from your activities

     

D. Describe how you will show that this improvement is happening or happened (or will know that it is not so you can learn and improve)

     

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Outcome StatementE. Name of the outcome you aim to create and report on (from list)

     

F. Describe what will improve and for who or what during or just after the work

     

G. Describe how you expect to this change to arise from your activities

     

H. Describe how you will show that this improvement is happening or happened (or will know that it is not so you can learn and improve)

     

Outcome StatementI. Name of the outcome you aim to create and report on (from list)

     

J. Describe what will improve and for who or what during or just after the work

     

K. Describe how you expect to this change to arise from your activities

     

L. Describe how you will show that this improvement is happening or happened (or will know that it is not so you can learn and improve)

     

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Section H: Funder Targeting

This information helps us comply with our own funder’s requirements to target social need

1. From which postcodes do your direct participants and users mainly come?

Use complete postcodes only please

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1. Organisation’s Bank Details

Account Name      

Bank/Building Society Name      

Bank/Building Society Address      

Sort code      

Account number      

Roll number (Building Society only)      

Please list all account signatories belowName Role or Position           

           

PART FOUR: DETAILS and

DECLARATIONInformation in this form will be used for assessment and monitoring purposes. Some details will also be recorded on a database, which will be used to gather general information that may be made public. However, individual details will not be made public without permission. If you would like to discuss this further, please contact the grants team. By submitting this application, you are declaring that an appropriate member of your organisation’s governing body has read and agreed to the above and has approved the content of the application.

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2. Organisation’s Acknowledgement Agreement

In signing below we undertake to acknowledge LCCC support in our promotional materials, including the logo on all print material

3. Organisation’s Declaration

I am the main contact and I declare that the information in the application is true and accurate

Name (Block capitals)      

Signature Date

I am a member of the applicant organisation and I declare that the information in the application is true and accurate

Name (Block capitals)      

Signature Date

PART FIVE: CHECK LIST

Please ensure that you have completed the following before submitting this application form:

Answered all the questions within this application form.

Signed the declaration at PART FOUR.

And enclosed the following:

A copy of your most recent Annual General Meeting minutes.

A signed copy of your organisation’s Constitution or Articles of Association (including the date of adoption)

A list of Committee Members for the current year.

A copy of the group/organisation’s most recent set of annual accounts –(i.e. the end of accounting period should not be prior to 31 March 2020)

Evidence of appropriate Public Liability insurance cover (£5M)

A copy of your Property Lease agreement (if applicable)

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A copy of your Safeguarding Policy

www.lisburncastlereagh.gov.uk/community

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